By TERRY LYNAM //
As New York State begins to reopen, it’s important to take a step back and assess what we’ve been through, and how we move ahead.
The impact of COVID-19 is more than just unprecedented. The virus has fundamentally altered society, office structure, economies, infrastructure and healthcare. Companies and cultural institutions are working toward establishing what the “new normal” will look like to keep everyone safe.
COVID-19 and the ways in which society has been forced to adapt have also helped us better understand what the future holds and what needs to be done to maintain public health. Now that the unprecedented has precedent, we are better prepared.
The first stage is helping facilitate recovery – for patients, hospitals and nursing homes that were overrun by those seeking care and scrambled to find adequate personal protective equipment for their employees.
As evident from the death toll, COVID-19 is a devastating disease and has severe respiratory symptoms. Though the number of new patients has declined significantly – Northwell’s caseload is now about 15 percent of its apex, nearly 3,500 COVID inpatients on April 7 – we cannot ignore the many chronically ill who are still recovering from the virus. Their ongoing care is an essential aspect of a community’s recovery.
COVID-19 has required many patients to receive tracheotomies to breathe with the assistance of a mechanical ventilator, often for weeks at a time, resulting in severe muscle loss and physical weakness. Being on a ventilator is a life-changing episode and requires significant rehabilitation and therapy to recover.
To help those who still need dedicated, expert, around-the-clock therapy, Northwell has created clinical teams dedicated to the long-term rehabilitation of COVID-19 patients being weaned off vents. Glen Cove Hospital is one of two sites where Northwell has established an acute ventilator recovery unit (along with Northern Westchester Hospital in Mount Kisco).
These new units provide patients with a meaningful chance at recovering from their prolonged illness and transitioning to a more traditional rehab facility. This effort also alleviates the stress on healthcare facilities trying to restore clinical programs that were essentially shut down in mid-March.
The rapid decline of COVID-19 cases doesn’t protect us from the threat of a second wave in the coming months. The concern among infectious-disease experts and other clinicians is that a second wave will be exacerbated if social distancing, the wearing of facemasks and other protective measures are ignored.
When the 1918 flu pandemic hit the United States, the first wave of infections occurred in March. A second, more-lethal wave followed in October, when the vast majority of deaths occurred. Many respiratory viruses follow similar patterns, with infection rates peaking in the fall and winter. Those seasonal viruses include some but not all strains of coronavirus.
With this in mind, businesses throughout the country are looking for a reliable way to reopen while still keeping their employees safe. While the focus is on infrastructure and disinfectants, which will undoubtedly help, there also needs to be an emphasis on medical wellness, including antibody (serology) testing and work-environment safety assessments.
However, most businesses and public entities lack the healthcare expertise to incorporate the ongoing monitoring and management necessary to operate in an environment where COVID-19 is still a threat.
To assist, Northwell launched Northwell Direct to create customized, proximal healthcare stations that provide some of these services, helping businesses reopen more safely. The program will manage the health of more than 500,000 individuals – among other steps, it conducts daily temperature checks of employees – to help prevent the virus from infecting the workplace and give returning workers a sense of security.
Another “new normal” will be significant reliance on telehealth services and other digital interventions to remotely assess and monitor patient health. As social distancing and work-from-home become more universally accepted, telehealth programs enable patients to meet with doctors more easily and seamlessly. Telemedicine can also help alleviate overcrowding at healthcare facilities, enabling healthcare workers to focus medical attention on those who need it most.
The elephant in the room, though, is a vaccine. As testing is already underway and showing promise, a vaccine could be available by early next year or even this fall – though there are still so many unanswered questions: Will it be effective? How will it be administered? Will it be mandatory? Who will have access to it?
The new normal will be different. But it will ultimately lead to better health outcomes and a better future.
Terry Lynam is a senior vice president at Northwell Health, New York State’s largest healthcare provider and private employer.